/pdf/nanopharmaceuticals-and-nanomedicines-currently-on-the-1kdng3jxna.pdf

Nanopharmaceuticals and nanomedicines currently on the market: Challenges and opportunities

This literature review provides an overview of recent studies on the introduction of nanosciences and nanotechnologies in secondary education. Four salient research topics have emerged: questions and reflections preceding curriculum development on nanosciences and nanotechnologies lessons; research on students’ conceptualisations of nano‐related concepts; the use of haptic tools to teach nanosciences and nanotechnologies; and professional development for secondary schools teachers. In a final critical discussion, the lack of studies in the literature considering nanosciences and nanotechnologies as a socioscientific issue in secondary education is emphasised. In addition, implications for future research as well as suggestions for nanosciences and nanotechnologies curriculum development are considered.

/pdf/nanosciences-and-nanotechnologies-learning-and-teaching-in-2nvl24kxi3.pdf

Nanosciences and nanotechnologies learning and teaching in secondary education: a review of literature

We present a Virtual and Augmented Reality multi-user prototype of a learning environment for liver anatomy education. Our system supports various training scenarios ranging from small learning groups to classroom-size education, where students and teachers can participate in virtual reality, augmented reality, or via desktop PCs. In an iterative development process with surgeons and teachers, a virtual organ library was created. Nineteen liver data sets were used comprising 3D surface models, 2D image data, pathology information, diagnosis and treatment decisions. These data sets can interactively be sorted and investigated individually regarding their volumetric and meta information. The three participation modes were evaluated within a user study with surgery lecturers (5) and medical students (5). We assessed the usability and presence using questionnaires. Additionally, we collected qualitative data with semistructured interviews. A total of 435 individual statements were recorded and summarized to 49 statements. The results show that our prototype is usable, induces presence, and potentially support the teaching of liver anatomy and surgery in the future.

A VR/AR Environment for Multi-User Liver Anatomy Education

In general, innovation governance models, which deal with organizational structure, innovation process, strategy and leadership, are becoming increasingly important for innovative companies for effective innovation management. Moreover, responsible innovation (RI) as a topic among academic scholars and policy makers is gaining importance, in order to address some of the ethical concerns and dilemmas as issues of governance in general and with special reference to technological innovations. This article attempts to show that technological innovation processes require a circular RI process instead of a linear one with embedded ethical decision-making framework for ethical innovation governance.

Innovation process and ethics in technology: an approach to ethical (responsible) innovation governance

The nanomedicine field is fast evolving toward complex, "active," and interactive formulations. Like many emerging technologies, nanomedicine raises questions of how human subjects research (HSR) should be conducted and the adequacy of current oversight, as well as how to integrate concerns over occupational, bystander, and environmental exposures. The history of oversight for HSR investigating emerging technologies is a patchwork quilt without systematic justification of when ordinary oversight for HSR is enough versus when added oversight is warranted. Nanomedicine HSR provides an occasion to think systematically about appropriate oversight, especially early in the evolution of a technology, when hazard and risk information may remain incomplete. This paper presents the consensus recommendations of a multidisciplinary, NIH-funded project group, to ensure a science-based and ethically informed approach to HSR issues in nanomedicine, and to integrate HSR analysis with analysis of occupational, bystander, and environmental concerns. We recommend creating two bodies, an interagency Human Subjects Research in Nanomedicine (HSR/N) Working Group and a Secretary's Advisory Committee on Nanomedicine (SAC/N). HSR/N and SAC/N should perform 3 primary functions: (1) analysis of the attributes and subsets of nanomedicine interventions that raise HSR challenges and current gaps in oversight; (2) providing advice to relevant agencies and institutional bodies on the HSR issues, as well as federal and federal-institutional coordination; and (3) gathering and analyzing information on HSR issues as they emerge in nanomedicine. HSR/N and SAC/N will create a home for HSR analysis and coordination in DHHS (the key agency for relevant HSR oversight), optimize federal and institutional approaches, and allow HSR review to evolve with greater knowledge about nanomedicine interventions and greater clarity about attributes of concern.

/pdf/recommendations-for-nanomedicine-human-subjects-research-fac9r1802j.pdf

Recommendations for Nanomedicine Human Subjects Research Oversight: An Evolutionary Approach for an Emerging Field

Nanomedicine is a top developing domain. However, there are neither sound rules, nor a proper legislation that might regulate the ethics in this domain. Here we discuss the main topics pertaining to the ethics in nanomedicine at this time. From issues such as equity and discrimination, to profound modifications of the human body, far beyond the limit of human and non-human, there are many ethical aspects that can give rise to conflicting opinions.

Ethical Issues in Nanomedicine

Background and aims A negative (R0) circumferential resection margin (CRM) is described as one of the most important factor that decrease the rate of local recurrence in rectal cancer. The primary outcome of the study was the status of the CRM, while the secondary outcomes were local recurrence and overall survival. Methods Study includes 192 patients with rectal cancer operated between January 2012 and December 2013 in our Institute. The incidence of positive CRM and its impact on the survival rates after oncologic surgical resection were investigated along with factors that determine positive CRM. R1 was defined as a distance of ≤ 1 mm between the tumor and the resection margin. Results The R1 rate was 3.6 % (7 cases). Nine patients (4.68%) developed local recurrence during a median followup period of 720 days. A positive CRM was found to be a risk factor of local recurrence (p-value = 0.031) and it decreased the overall survival (p-value=0.001). pT4 stage (p-value=0.008) and vascular invasion (p-value=0.005) are factors that play significant roles in determining CRM positivity. In case of inferior rectal tumours abdomino-perineal resection (APR) determines significantly higher (p-value=0.048) rates of positive CRM than anterior resection (AR) of the rectum. Conclusions Positive CRM affects overall survival and local recurrence in rectal cancer. pT4 stage and vascular invasion play determinant roles in determine CRM status. APR is a risk factor for positive CRM in inferior rectal tumors. Key words Abdomino-perineal resection, Circumferential resection margins, Local recurrence, Rectal cancer, Overall survival.

The influence of circumferential resection margins on survival following rectal cancer surgery.

The rapid expansion of laparoscopic surgery has led to the development of training methods for acquiring technical skills. The importance and complexity of laparoscopic liver surgery are arguments for developing a new integrated system of teaching, learning and evaluation, based on modern educational principles, on flexibility allowing wide accessibility among surgeons. This paper presents the development of e-learning platform designed for training in laparoscopic liver surgery and pre-planning of the operation in a virtual environment. E-learning platform makes it possible to simulate laparoscopic liver surgery remotely via internet connection. The addressability of this e-learning platform is large, being represented by young surgeons who are mainly preoccupied by laparoscopic liver surgery, as well as experienced surgeons interested in obtaining a competence in the hepatic minimally invasive surgery.

[The advantages of implementing an e-learning platform for laparoscopic liver surgery].

The hilar and intrahepatic location represents the most frequent positioning of cholangiocarcinoma. Late diagnosis, tumour resection - as the sole method of radical treatment require a multimodal approach of this form of malignancy. Material and methods. The paper is based on a retrospective study conducted on a series of 56 patients diagnosed with hilar and peripheral cholangiocarcinoma admitted and treated in the 3rd Surgical Clinic Cluj-Napoca between September 2004 - December 2010. The series included patients treated with radical or palliative surgical treatment, or patients who underwent minimally invasive treatment of biliary endoscopic or percutaneous drainage followed or not by surgery. We analyzed the data on the postoperative morbidity and mortality, surgical re-interventions, the percentage of patients who received curative resection with radical intention or palliative treatment. Conclusions. Cholangiocarcinoma is an aggressive form of cancer and commonly diagnosed late. The cholangiocarcinoma resectability results are comparable to those in literature and may be improved by increasing the number of tumor resections with negative resection margins. The main goal of the palliative procedures is the improvement and remission of the obstructive jaundice, in most cases being successful. The multimodality of the cholangiocarcinoma treatment is a reality, but also a goal in the group of patients studied, the number of patients in which the sequential treatment biliary drainage – surgical treatment were applied being still low.

/pdf/the-multimodal-treatment-of-central-and-peripheral-384cmcywun.pdf

The multimodal treatment of central and peripheral cholangiocarcinoma – analysis based on a single center experience

Three-dimensional reconstructions of the liver will be used to develop a new laparoscopic liver surgery simulator. The first step on this way is to develop a realistic virtual model from CT-scans, and then, using finite element analysis, consistency will be associated with different structures and tumors within the liver. This study aims to find the best way to obtain a 3D liver reconstruction with inner structures which will be used later for a finite element analysis. The protocols for slices acquisition from CT-scanner are presented. Also a comparison between reconstructions with dedicated software from CT-scanner providers (method 1) and image reconstruction software (method 2) are performed. The first method obtains 3D reconstructions faster than the second method, but these images cannot be used for a finite element analysis. On the other hand the second method obtains 3D reconstructions harder, but these images can be used for finite element analysis and utilized later to develop a virtual environment for integration in laparoscopic simulator.

Liver 3D Reconstruction Modalities – The First Step toward a Laparoscopic Liver Surgery Simulator

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